A heart attack can strike anyone. It is estimated that 70,000 heart attacks occur in Canada each year, one every 7 minutes.
The most recent data, gathered in 2012-13, show that approximately 2.4 million Canadian adults, or 1 in 12 aged 20 and older, were living with arteriosclerotic heart disease (IHD) or coronary artery disease, 578,000 of whom had a history of acute myocardial infarction.
Another 669,600 Canadian adults aged 40 years and older experienced heart failure.
Raising awareness a must
The chances of experiencing cardiovascular disease during one's lifetime are much higher than most people realize. The Heart and Stroke Foundation of Canada estimates that 9 out of 10 Canadians have at least one risk factor, but only 12% are aware of it. Heart disease and stroke are among the leading causes of hospitalization and prescription drug use, and among the main factors driving disability in the country.
Widespread cardiovascular disease is a relatively recent phenomenon. Québec environmental cardiologist François Reeves points out that this condition was much less common in the pre-industrial era. Between 1900 and 1950, however, the number of heart attacks quadrupled in the United States with the advent of the industrial era. This demonstrates the close link between work and cardiovascular disease.
Contrary to popular belief, it is not only stressed-out executives working 60 hours or more a week who are at risk of developing cardiovascular disease: a well-known English study, Whitehall 1 and 2, showed that the risk of death from heart disease was 2.2 times higher in the lowest group in the occupational hierarchy than in the highest. Workers are thus at greater risk than their bosses.
The Whitehall study finds that chronic stress at work increases cardiovascular risk by modifying some cardio-metabolic parameters. Conversely, it also highlights that a sense of organizational justice at work reduces cardiovascular risk. People experience organizational justice when they feel that their supervisor considers their point of view, shares information regarding decision making and treats individuals fairly. Other research demonstrates increased cardiovascular risk among people who regularly work long hours.
The heart attack, the best known and most feared heart condition, is the culmination of ischemic coronary artery disease, the most common form of heart disease. Angina is another sign of coronary artery disease.
Coronary artery disease is only one of six forms of cardiovascular disease (CD). The others are cerebrovascular disease, which can lead to stroke; peripheral vascular disease, which mainly affects blood flow in the legs; heart failure, which causes shortness of breath and swelling in the legs; rheumatic heart disease; and congenital heart disease, which affects children in particular. Mortality rates associated with cardiovascular disease increase significantly in men aged 45 and over and in women aged 55 and over.
Major determinants
Age and gender are major determinants of heart disease. Men between the ages of 25 and 44 are about four times more likely to have a heart attack than are women in the same age group.
In Canada, 7% of men and 5% of women reported having cardiovascular disease in 2014. Men are more likely than women to report having heart disease, at 5.3% versus 4.2%. They are also more likely than women to die from cardiovascular disease, a figure that almost triples for males under age 65.
Age-specific prevalence and incidence rates of diagnosed coronary heart disease and heart failure were higher among men than women over a 13-year period, the Public Health Agency of Canada finds, as was heart attack frequency. For part of their lives, women are less susceptible to coronary heart disease than men, but after menopause they become just as vulnerable, if not more so.
In addition, the risk of developing heart disease increases with age. Cardiovascular disease becomes a more serious threat after age 55 for men and after age 65 for women. At age 55, someone with poor lifestyle habits may have a heart equivalent to that of a person 65 years old, several studies consulted for this report maintain.
One in four men over age 75 has coronary heart disease, but as women get older, they are more likely to suffer from heart disease. In 2012-13, the Canadian government found that there are almost twice as many women 85 and older newly diagnosed with coronary heart disease as there are men of the same age. Because women live longer than men, they are more likely to be diagnosed with heart disease later in life.
Prevalence of coronary heart disease
According to the World Health Organization (WHO), heart disease and stroke are the first and second leading causes of death worldwide. The WHO predicted that by 2030, 23.4 million people will die from heart disease and stroke, compared with 11.8 million due to cancer.
In Canada, the picture is quite different. Until 2005, cardiovascular disease was the leading cause of death, the Canadian Cancer Society reports. Today, cancer claims the most lives in the country.
Heart disease is now second only to cancer, the Public Health Agency of Canada confirms. All the same, coronary heart disease is the leading cause of loss of years of life due to premature death, and the second foremost cause of disability.